A Case of Bilateral Baxter's Neuropathy Secondary to Plantar Fasciitis

Heel pain is 1 of the most common presentations to the foot surgeon, and its causes are multifactorial. Baxter's neuropathy is caused by an impingement of the inferior calcaneal nerve and has been reported to be responsible for up to 20% of heel pain. The diagnostic imaging features are striking, with inflammation or atrophy of the abductor digiti minimi muscle. Multiple studies have found that the prevalence of this finding is much greater than initially thought. However, it is more unusual to find bilateral and symmetrical features. The possible causes of this condition lie along the course of the inferior calcaneal nerve. Management is focused on treating the underlying condition, with conservative therapy and steroid injection as the mainstay. Refractory cases may require surgical release. We present the case of a 56-year-old female presenting with bilateral foot pain. Imaging reveals symmetrical abductor digiti minimi atrophy associated with bilateral plantar fasciitis. These appearances are well demonstrated on both magnetic resonance imaging and ultrasound.